Stellate cells in health and disease

Hepatic stellate cells (HSCs), despite having a subconscious knowledge of understanding of their important role in liver fibrogenesis by many gastroenterologists and basic medical researchers, have not received enough importance to put all the known facts and literature in one compact easily accessible form. This book in its present form covers all aspects of HSCs in physiological and pathological conditions both in experimental animal models and in clinical setting. It also talks about the in vitro culture system(s) for HSCs thereby presenting the knowledge comprehensively.

The authors start with a chapter which deals with the historical aspect of identification of stellate or Ito cells and the molecular markers using appropriate illustrations. The next chapter deals with in vitro isolation and characterization of HSCs. Role of HSCs in liver fibrogenesis, hepatocytic functions, interactions with various cytokines including a discussion on the functions of the senescent HSCs, immune modulation, transformation to myofibroblasts and in epithelial to mesenchymal transitions in various disease conditions. Hence these chapters cover the nuts and bolts of the historical aspect of HSCs, the histology and molecular markers. All chapters are well presented, easy to read and understand.

HSCs and other mesenchymal cells that are normally present in portal tracts have been discussed in detail under various clinical conditions where liver undergoes fibrosis and develops cirrhosis. Not only have these been studied in animal models where HSCs have been induced but also in depleted models, in order to understand the critical roles of HSCs better, with the prospect of preventing and inhibiting their uncontrolled proliferation and collagen deposition leading to irreversibly fibrotic and cirrhotic liver. Due to their property similar to pericytes, HSC are also believed to have an important role in the development of portal hypertension.

The authors have also described in detail the roles played by HSCs in modulation of immunological milieu within the microenvironment. These are believed to create an environment where immune modulating properties of HSCs and liver fibrosis together have carcinogenetic impact on hepatocytes. The chapter on stellate cells in hepatic immunological tolerance discussed comprehensively the roles played by HSCs in transplanted liver as these have key roles in the production of inflammatory and immunoregulatory cytokines and chemokines. The authors have also gone beyond liver to study the stellate cells. They have also discussed stellate cells in initiation and development of pancreatic fibrosis and in chronic pancreatitis under different conditions.

Overall, this book provides contextual learning with comprehensive references and clearly defined essential highlighted headings and subheadings on each page. Visual prompts with histological illustrations and flow charts are educative. Also, clinical questions and their implications are discussed well in each chapter.

This book has targeted medical students, researchers of basic medical sciences and practicing clinicians in the field of gastroenterology. This book is recommended to anyone who is on the look-out for a book to introduce them to the field of liver and pancreatic fibrosis and underlying fibrogenetic mechanisms.